Intraoperative functional MRI using a real-time neurosurgical navigation system

A 42-year-old-man had focal left hand motor seizures. MR studies demonstrated a right posterior frontal brain tumor. Functional MRI was performed, localizing the motor cortex posterior to the lesion. The functional images were integrated with a neurosurgical navigation computer. A real-time intraoperative display of the anatomic and functional images was produced, registered to a neurosurgical probe. Excellent correlation was demonstrated between the functional maps and invasive electrophysiologic mapping performed at the time of craniotomy.